High Tibial Osteotomy Surgery

What is a high tibial osteotomy?

High tibial osteotomy (HTO) is a surgical procedure that is used to realign the bones that form the knee joint, to prevent development or progression of arthritis in one compartment of the knee. Its primary goal is to reduce pain, improve function, and delay the need for joint replacement surgery.

How does a high tibial osteotomy work?

Angular deformity, such as bowing of the knee, can lead to increased distribution of weight through one part of the knee. This can lead to accelerated wear and tear of the cartilage in the knee and lead to degeneration. Injuries such as previous knee fracture/dislocation and meniscus injury, can also cause accelerated cartilage degeneration and cause post-traumatic arthritis.

During an HTO, I will cut the shin bone (tibia) and realign it so that the weight-bearing forces are directed away from the damaged part of the knee to a healthier area. This will offload the damaged part of the knee.

The cut shin bone will be secured in place with a metal plate and screws

The cut shin bone secured in place with a metal plate and screws.

Who is a good candidate for high tibial osteotomy?

  • This surgery is typically recommended for younger and active population (<55 years) who are deemed too young for joint replacement surgery, especially those in heavy physical employment.
  • Patients who have sustained cartilage injury and/or require cartilage restoring surgery may also be a candidate for HTO, as realigning the weight-bearing forces will protect the injury/surgical site.

Anterior Cruciate Ligament (ACL)


High Tibial Osteotomy




Patella Dislocation

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03 390 0010


Elmwood Orthopaedics
Level 3, 11 Caledonian Road
Saint Albans, Christchurch 8014